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UP/SA/IP <br /> ad <br /> AUTHORIZAVON 5IGNATed 4 <br /> U . ad a ad <br /> -p <br /> a r <br /> dqF <br /> ad <br /> aF <br /> 1 1 <br /> I <br /> r 1 <br /> da <br /> ONLY THE OWNER OF THE PROPERTYOR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees from any <br /> claim, action or proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that I am (check one) : <br /> ❑ Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> X Legal agent (attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalo <br /> and that the foregoing application statements are true and correct. <br /> Print Name: Aaron J. Smud Signature: Date: 3/4/20 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date : <br /> Mountain HouselMH Application FormslMH-UP-SA4P form-MASTER. doc <br /> 1d <br /> ad <br /> nskcin* <br />